Abstract

Simple SummaryAcute myeloid leukemia (AML) is a cancer of blood and bone marrow that causes rapid production of abnormal red and white blood cells. Once established, the cancer cells communicate through a complex set of molecular interactions with neighboring cells in order to survive, spread rapidly, and evade detection and destruction by the body’s immune system. In this study, a systematic review produced a comprehensive set of critical molecular interactions that was then organized into molecular “systems architecture” to map the communications between cancer cells and neighboring cells. This systems architecture may aid in identifying effective targets that disrupt communication between the cancer cells and the neighboring environment, leading to effective treatment strategies.A molecular systems architecture is presented for acute myeloid leukemia (AML) to provide a framework for organizing the complexity of biomolecular interactions. AML is a multifactorial disease resulting from impaired differentiation and increased proliferation of hematopoietic precursor cells involving genetic mutations, signaling pathways related to the cancer cell genetics, and molecular interactions between the cancer cell and the tumor microenvironment, including endothelial cells, fibroblasts, myeloid-derived suppressor cells, bone marrow stromal cells, and immune cells (e.g., T-regs, T-helper 1 cells, T-helper 17 cells, T-effector cells, natural killer cells, and dendritic cells). This molecular systems architecture provides a layered understanding of intra- and inter-cellular interactions in the AML cancer cell and the cells in the stromal microenvironment. The molecular systems architecture may be utilized for target identification and the discovery of single and combination therapeutics and strategies to treat AML.

Highlights

  • Acute Myeloid Leukemia (AML) is characterized by uncontrolled proliferation, increased survival, and impaired differentiation of hematopoietic progenitor cells [1]

  • Aberrant and constitutive activation of signal transduction molecules are found in about 50% of primary AML bone marrow samples, enhancing the survival and proliferation of hematopoietic progenitor cells via the RAF/MEK/ERK cascade and the PI3K/AKT pathways that are dysregulated by mutations in receptor tyrosine kinases (RTK), Fms related receptor tyrosine kinase 3 (FLT3), N-Ras and K-Ras, and Kit [1,4]

  • Leukemic stem cells are characterized by CD34+/CD38− surface markers, megakaryocyteerythroid progenitors (MEPs) are characterized by CD34+/CD38+/CD45RA− surface markers, and granulocytic-monocytic progenitors (GMPs) are characterized by CD34+/CD38+/ CD45RA+ surface markers [5,6,7]

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Summary

Introduction

Acute Myeloid Leukemia (AML) is characterized by uncontrolled proliferation, increased survival, and impaired differentiation of hematopoietic progenitor cells [1]. Increased proliferation and apoptosis resistance, as well as the inhibition of differentiation and/or aberrant activation of growth factor receptor signaling pathways, are central to AML pathogenesis [2,3]. In addition to cytogenetic factors, the interactions in the tumor microenvironment that promote suppression of immune response, cancer cell proliferation, and inhibition of apoptosis contribute significantly to the pathogenesis of AML [2]. The insights from this review aim to provide the AML research community an integrative molecular systems approach to understanding the complexity of the biomolecular interactions involved in AML pathogenesis. The results of this investigation may be used to support identification of potential targets for therapeutic interventions

Literature Review
Molecular Systems Architecture of AML
Interactive Signaling in the AML Microenvironment
TGF-β Signaling
Interactive Signaling AML Cells and Immune Cells
Interferon α Signaling
Immunosuppressive Interactions of Tregs in AML Tumor Microenvironment
Immunosuppression Interactions of AML Cells with T Cells
Discussion
Findings
Future Directions
Conclusions
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